One of the scourges of modern medicine is the over-prescription of antibiotics. The more they are used, the more chances are made for target organisms to develop resistance. ( as well as other bacteria that live alongside them) Hence the current crisis. Everyone agrees we should be saving our last antibiotics for when they are really, really needed, not just throwing them at every random infection presented in the Doctor’s surgery on a rainy Monday morning.

A typical example is infections of the urinary tract, as James Gallagher explains for the BBC. [1] It’s never easy to know whether one of these is bacterial or viral. And currently it can take three days to find out. Yet the risk of an untreated bacterial infection is so high, the consequences so grave, that Doctors have to prescribe antibiotics, just in case. Of course, if it turns out to be viral. the antibiotics are useless, and the risk of adding more resistant bacteria to the ecosystem has just been ratcheted up again.. If only there was a way of cutting diagnostic time!

Well some Swedish researchers seem to have done just that. Their new test seems to have cut the time to answer the question “is this an antibiotic-treatable infection?” down to 45 minutes. James waxes lyrical, with the aid of some excellent graphics. Even more encouraging, the system is now being marketed by a pioneering firm called Sysmex Astrego [2] which suggests a strongly robust, repeatable test which could be rolled out in the millions. Billions, even? There’s lots of good news here, and we hope that all involved enjoy their Longitude Prize. If anyone deserves a little celebration, it is surely they.

[1]https://www.bbc.co.uk/news/articles/crggj9led0no

[2]https://www.sysmex-astrego.se/

#antibiotic resistance #medicine #bacteria fungi virus #superbug

We have always hoped that AI would do for antibiotics what it has already done for protein design. (LSS 1 12 20; 26 3 23) Now there is a real possibility that these hopes may come true. Eric Berger of the Guardian covers a truly remarkable set of research by Professor de la Fuente and his team at the University pf Pennsylvania. [1] They have used an algorithm to mine vast sets of data to sieve out any compounds with potential anti microbial properties. As any reader will know, it would have taken years, if not decades, if they had just used teams of scientists in labs. Click on to Eric’s article, its very easy on the eye. But we’ll leave you with these thoughts:

Is this a game changer? Potentially, yes. It could allow the construction of a vast library of potential antibiotic compounds. The real problem of the last forty years has been, not just the steady failure of existing antibiotics, but the lack of a stream of potential replacements as resistance builds up. But we see a deeper lesson, good for all science. There is nothing so cooperative, so international, as a library or a database. Its contents cut across divisions of nationality, race, class, time even. If we are to survive the antibiotics crisis, and many other looming threats, we will need this approach more. Something to think about when some journalist or politician turns a group of people into “others”. Maybe we can learn something from them, instead.

[1]https://www.theguardian.com/society/article/2024/jun/05/ai-antibiotic-resistance

#antibiotics #AI #microbiology #research #database

One of our stated purposes at LSS is to scan the media feeds, both news and scientific, to bring you the best possible stories on the continuing crisis caused by antibiotic resistant micro-organisms. That’s superbugs in short. And one journalist whose work we have featured time and again is the indefatigable Nicola Davis who writes for the Guardian. Well today she has done it again, in an intriguing new take. It’s going to take quite some time before new drugs can be tested and made ready. Meanwhile people are starting to die, in quite large numbers. What can we do? [1]

Well, quite a lot according to Nicola. Like a good journalist, she starts by reprising how truly awful the current situation is. The figures are eyewatering. To take 2019 as a good pre COVID baseline, antibiotic resistant microorganisms were implicated in 4.95 million deaths, with a definite attribution possible in 1.27 million cases. So are we just going to wait, to sit around and wring our hands until new antibiotics come along? No, quite a lot is possible in the meantime, Citing the work of Professor Laxminarayan of Princeton, she writes:

……………AMR-associated deaths in LMICs could be cut by 18%, equivalent to about 750,000 a year, through three key steps……..The team team suggests an estimated 247,800 deaths are preventable through universal access to clean water and improved sanitation and hygiene, while 337,000 deaths could be prevented through better infection prevention and control in healthcare settings…….Another 181,500 deaths are preventable by means of childhood vaccinations,

But Nicola’s article, and the link she provides to The Lancet, are far more detailed [2]

An our thoughts? After so many years bashing you on your heads, gentle readers, we see actual grounds for optimism First journalists like Nicola are getting on to this.( See also MD of Private Eye and Stacey Liberatore of the Mail) Secondly, there’s nothing so likely to wither effort as the thought that we are powerless. Beyond hope. Passive. And as this article shows, nothing could be further from the truth.

[1]https://www.theguardian.com/society/article/2024/may/23/huge-number-of-deaths-linked-to-superbugs-can-be-avoided-say-experts

[2]https://www.thelancet.com/series/antibiotic-resistance

#superbugs #antibiotic resistance #pandemic #health #vaccination #sanitation #preventive medicine #nicola davis #md private eye #stacey liberatore

article of the week

Long, long ago, back in the 1940s, there was a set of beliefs called Keynesianism. It prized economic growth over financial targets and general welfare over the accumulation of vast quantities of lucre. Its prizing of State intervention and higher taxes won the Second World War, and led to thirty years of prosperity and technological advance. But it had its critics. And they had all the money, and therefore all the newspapers. Poor old Keynes was doomed.

Among the advances of those years of public-private partnership there were many advances. Computers and IT, semiconductors, aviation, space technology….but one has been forgotten. It was these years that Ernst Chain and others were able to take the discoveries of Alexander Fleming and turn them into the first generation of mass antibiotics. It was a revolution in health care. And, it has to be said a great reduction in human suffering. Yet enter the Free market Fundamentalists in 1979, and antibiotic development fell by the way. Why? There’s no money in it. And slowly resistance crept back, slowly at first until today, when we balance on the edge of another great pandemic.

But there is hope. Today Nature Briefings reveals that, by throwing out the profit motive, two exciting new antimicrobial drugs have been developed. Allow us to scrap this from Nature

Successful trials of two new antimicrobial drugs — zoliflodacin for drug-resistant gonorrhoea and an antifungal, fosravuconazole — were conducted by non-profit organizations that were founded specifically to bring such drugs to the market. Most legacy pharmaceutical firms have withdrawn from the field, and many of the small biotechnology companies that picked up the torch have gone bankrupt. These two latest achievements suggest that non-profits could help to solve the problem of drug access, while fending off the rise of drug-resistant microbes, which contribute to almost five million deaths per year.Nature | 10 min read

Now, there is a link there to a superb article by Maryn McKenna, which we honestly think you should read as well. But nothing so sums up the belief of this blog so fully. Wealth is about so many more things than just money.

#antibiotics #jm keynes #research #science #economics